The two main goals of atrial fibrillation (AFib) treatment are to regulate the heartbeat and to prevent a stroke. Advances in treatment, including new medications and procedures, have been made to help those with AFib.
Anticoagulants are drugs that prevent blood clots from forming and prevent a stroke.
People with AFib usually have a very rapid heart rate. This is because the electrical impulses in the atria cause the ventricles, the two main chambers in the heart, to beat irregularly or too rapidly. When this happens, the ventricles don’t have a chance to fill with blood or empty completely. This causes inefficient blood pumping. As a result, blood can pool in the atria and possibly form clots.
Warfarin (Coumadin) has been widely used as an anticoagulant drug since the 1950s. The FDA has since approved three new blood thinners:
- dabigatran (Pradaxa)
- rivaroxaban (Xarelto)
- apixaban (Eliquis)
These newer drugs may reduce the risk of stroke. They can also have fewer side effects, such as risk of unwanted bleeding in the brain or stomach. Warfarin tends to be less expensive, but it also requires blood tests to monitor the effects. People who take warfarin have to regulate what they eat. For example, foods with a lot of vitamin K may make warfarin less effective.
Drugs called antiarrhythmic drugs are used for cardioversion, a technique for returning the heart back to a normal rhythm. Examples of these drugs include:
- amiodarone (Cordarone)
- propafenone (Rythmol)
- sotalol (Betaspace AF)
- flecanide (Tambocor)
Dofetilide (Tikosyn) and dronedarone (Multaq) are newer medications, but they may actually worsen an irregular heartbeat. It’s important to be aware of any unusual symptoms like:
- fast or irregular heartbeat
- swelling in the feet and legs
- shortness of breath
Surgeries, electrical shock treatments, or implanting a pacemaker are three other options for cardioversion.
Catheter ablation is a minimally invasive procedure that can help reduce AFib symptoms. During this procedure, a surgeon places a thin tube with an electrode into a blood vessel in the arm, neck, or groin. The tube is then pushed through the blood vessels into the heart. Heat or extreme cold is applied through the tube to the abnormal electrical pathways in the heart. This destroys the abnormally functioning tissue and creates a scar in its place. These scars help block irregular electrical signals that can contribute to AFib symptoms.
According to the American Heart Association, approximately 2.7 million Americans have AFib. Because of this, researchers are looking for newer ways to treat the condition. One of these new developments is radioablation.
This procedure previously has been used to destroy heart tissue that causes abnormal heart rate or rhythm. Researchers are now looking at a new system using radioablation to map specific targets. This system could double the success rate of treatment.
Other trials are looking to stop blood clots from occurring. Blood clots are particularly likely to form in an area of the left atrium called the left atrial appendage. There are currently several ongoing trials of devices that block clots in the heart’s left atrium from going to the rest of the body.
Experimental trials involving catheters are also underway. Researchers are trying several techniques that build on past methods of treatment to more effectively and safely destroy abnormal tissue. These new treatment methods are providing hope to those living with AFib.